Compression Stockings for Varicose Veins: How to Choose and Wear Them

Written and medically reviewed by Dr. Prashanth J V MBBS, MS (General Surgery), FMAS, FISCP, DMAS

Consultant Laparoscopic & Laser Surgeon · 27+ years in practice · Karnataka Medical Council Reg. No. 41048 · Last reviewed: 5 October 2026

✓ Medically Reviewed

Compression stockings are the most commonly recommended first step for varicose veins, and also the most commonly misused. Stockings bought in the wrong size, pulled on in the evening when the legs are already swollen, or left in a drawer because they are too hot to bear, do very little.

Worn correctly, they genuinely ease aching, heaviness and ankle swelling. This guide explains what they do, how to choose them, and how to make them bearable in a Bangalore summer.

How Compression Stockings Work

In varicose veins, faulty valves let blood fall back down the leg, raising the pressure in the veins near the ankle. Medical compression stockings are graduated: they squeeze hardest at the ankle and progressively less towards the knee and thigh. That gradient narrows the stretched veins, helps the valves that still work to close, and pushes blood upward towards the heart. The result is less pooling, less swelling, and less of the dull ache that builds through the day.

What they cannot do is repair the valves. The benefit lasts only while the stockings are on. A 2021 Cochrane review found too little high-quality evidence to say whether stockings, used on their own, are an effective first treatment for varicose veins. That is why NICE advises against offering them as the treatment for varicose veins unless a procedure is unsuitable: they are best understood as symptom control.

Who Benefits Most

• People with aching, heavy or swollen legs who are waiting for, or choosing not to have, a procedure
• Pregnant women with varicose veins, for whom procedures are deferred until after delivery
• People who stand or sit for long hours at work
• Long journeys by air, road or rail, to reduce swelling
• After laser ablation or foam sclerotherapy, for a short period your surgeon advises
• Venous leg ulcers and severe swelling, where stronger compression is applied under medical supervision

Choosing the Right Pressure

Stockings are graded by the pressure they apply at the ankle, measured in millimetres of mercury (mmHg). Manufacturers label them by class, and the class numbering differs between standards, so always look at the mmHg figure rather than the class number alone.

Stronger is not better. Pressure that is too high for you is uncomfortable, discourages wear, and can harm a leg with poor arterial circulation.

Knee-High or Thigh-High?

Knee-high stockings suit most people. They are easier to put on, cooler, and more likely to be worn every day, which matters more than length. Thigh-high stockings or tights are used when varicose veins extend above the knee or swelling involves the thigh, and are sometimes advised after a procedure on the thigh vein. Your doctor will tell you which you need.

Getting the Size Right

Medical stockings are sized by measurement, not by shoe size. Measure first thing in the morning, before the legs swell:

• The narrowest part of the ankle
• The widest part of the calf
• For thigh-high stockings, the widest part of the thigh
• The length from the floor to the bend of the knee, or to the top of the thigh

Compare these with the manufacturer's chart. If you fall between sizes, ask for advice rather than guessing. A stocking that is too tight at the top can act like a tourniquet; one that is too loose does nothing.

How to Put Them On

1. Put them on in the morning, before getting out of bed if possible, when the legs are least swollen.
2. Turn the stocking inside out down to the heel.
3. Slide your foot in and pull the heel into place.
4. Ease the stocking up the leg a little at a time, smoothing as you go. Do not grab and drag the top.
5. Check for wrinkles, especially at the ankle and behind the knee, and never fold or roll the top down.

Rubber household gloves give a much better grip and protect the fabric from fingernails. Donning aids, simple frames that hold the stocking open, help people with arthritis, back problems or limited reach.

Living With Stockings in Bangalore's Heat

• Choose a breathable fabric and a knee-high length if your doctor agrees.
• Moisturise your legs at night rather than in the morning, so the skin is not sticky when you put stockings on.
• Wash them daily in lukewarm water with mild soap and dry them flat, away from direct sun and heat.
• Keep two pairs, so one can be washed while the other is worn.
• Replace them every three to six months, or sooner if they lose their stretch.

When Stockings Are Not Safe

Compression can be harmful in some situations. Do not start wearing firm compression stockings without medical advice if you have:

• Peripheral arterial disease, or weak or absent foot pulses. A simple ankle-brachial pressure index (ABPI) test checks the circulation first.
• Diabetes with reduced sensation in the feet, because pressure damage may go unnoticed.
• Fragile skin, skin infection, or an open wound that has not been assessed.
• Severe heart failure with marked leg swelling.

Take the stockings off and seek advice if your toes become pale, blue, cold, numb or painful, or if you see red marks or skin breakdown where the stocking presses.

When It's Time to Think Beyond Stockings

If you find yourself relying on stockings every day for years, still aching despite wearing them, or noticing changes in the skin around the ankle, it is worth having a Duplex ultrasound to see whether the leaking vein can be treated. Endovenous laser ablation closes the faulty vein under local anaesthesia, and most people then need stockings for only a short period afterwards. See our guide to varicose vein treatment in Bangalore, and what else helps in varicose veins without surgery.

Dr. Prashanth J V

MBBS · MS (General Surgery) · FMAS · FISCP · DMAS · Advanced Laser Vein Training, AVIS Vascular Centre · KMC Reg. 41048

This article is general health information and does not replace an individual consultation, examination and Duplex ultrasound.